| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,424 |
1,410 |
$64K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,485 |
1,471 |
$64K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,831 |
1,797 |
$51K |
| 92015 |
Determination of refractive state |
2,785 |
2,747 |
$43K |
| V2020 |
Frames, purchases |
382 |
381 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
184 |
184 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
77 |
77 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
143 |
143 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
14 |
$981.85 |
| V2025 |
Deluxe frame |
64 |
62 |
$912.60 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
30 |
$325.38 |